Mind and Body

Did you like our March issue’s interview “Across the Board, Peace” with addiction-recovery worker, supporter of the consistent-life ethic, and all-around character Jim Balmer? Wait, there’s more!

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Below are some of his additional thoughts inspired by years helping others recover from addiction. Sojourners associate editor Elizabeth Palmberg interviewed Balmer early last year at the Consistent Life conference in Washington, D.C.

How did you get started working in addiction recovery?I got sober in 1971; however I actually spent the first years of my career, until I came to Dawn Farm in ’83, not working with addicts. I worked for a number of years for the local community mental health center and had a fairly diversified career. I worked with couples and adolescents, I consulted to an emergency room, and I was on the local police hostage negotiation team. Mental health people often aren’t very literate about addiction, and addiction treatment people are often not very literate about mental health. I had the opportunity to straddle both worlds.

What are some of the misunderstandings that happen there?I think it just tends to be a lack of understanding—addiction professionals often don’t have a good framework for understanding mental health issues, and I think mental health folks suffer from the same problem.

Realistically, if you’re an addict and you’re anxious and you show up at your average psychiatrist’s office, the chance of being diagnosed bipolar and being put on meds is pretty high. The misdiagnosing or underdiagnosing or overdiagnosing on both sides is an ongoing problem.

At Dawn Farm, we’ve written some position papers that have been controversial on the subject. But you know, we don’t mind being controversial. Because we’ve survived 39 years, we sort of see ourselves as having a greater role in terms of just saying things that we believe to be true.

What form does the controversy take?Number one, some of the big popular treatments—we’ve come out very openly about the subject of serotonin drugs, anti-depressants. Many years ago we wrote a position paper on antidepressants that continues to get cited; we feel like addicts and alcoholics get overdiagnosed with psychiatric co-morbidity all the time. And some of moves toward opiate replacement therapy—we have opinions.

Based on your work at Dawn Farm, do you have any health policy suggestions you’d like to share with our readers?Oh, well, one of the biggest national issues that affects everybody is the absence of what we call parity for addiction treatment—parity with other chronic disease.

The reality is we know a lot about addiction. We know more and more. We know that addiction isn’t hedonism, it’s not a character problem, it has a biological origin—people’s mesolimbic pathways are wired differently. It produces lots of behavioral symptoms, but we know that its origins are in the brain. We know that when we talk about it as a disease, we’re not being euphemistic. It really is a disease.

The best working example that we often use is diabetes, which often has behavioral aspects to it. You’ve got people who don’t take care of themselves, people who eat too many sweets, but if you’re a diabetic and you show up in a hospital, they’ll treat you. If you’re an alcoholic and the same is true, they won’t. Routinely, people will say, “Well, we don’t have addiction treatment beds.”

Why aren’t those beds there?Your insurance policies have severe limits. With managed care, the 28-day treatment centers, like in the Sandra Bullock movie, which used to be the norm—now they’re all completely gone. Combine that with the dramatic decrease in public funding for treatment, you have a situation where the problem has not changed, but the number of options has.

I just read some place that 10 percent of the people that have addictions in the United States are able to access treatment. Ten percent. And I just read a study that 14 percent of the American population is affected by addiction.

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